Duchesne Charlène, Faure Patrick, Kohler François, Pingannaud Marie-Pierre, Bonnaud Guillaume, Devulder Franck, Abramowitz Laurent, Boustière Christian, Peyrin-Biroulet Laurent
INSERM U954 and Department of Hepato-Gastroenterology, Université de Lorraine, France.
Department of Hepato-Gastroenterology, Clinic St Jean Languedoc, Toulouse, France.
Dig Liver Dis. 2014 Aug;46(8):675-81. doi: 10.1016/j.dld.2014.04.004. Epub 2014 May 6.
Data on the current management of inflammatory bowel disease are scarce.
This was a nationwide survey among 65 private gastroenterologists treating patients with inflammatory bowel disease in France in 2012.
A total of 375 inflammatory bowel disease patients were analysed: 48% had ulcerative colitis. One third of inflammatory bowel disease patients had a history of hospitalisation, and 40% of Crohn's disease patients had prior surgery. Two thirds of inflammatory bowel disease patients had active disease. Significantly fewer ulcerative colitis patients were treated with anti-tumour necrosis factor therapy than Crohn's disease patients (18.9% vs. 38.9%; p<0.0001). Among patients treated with anti-tumour necrosis factor, only 4.5% were receiving concomitant immunomodulators. Half of inflammatory bowel disease patients had undergone a colonoscopy within the past year. For colorectal cancer screening, random biopsies and chromoendoscopy were performed in 75% and 40% of cases, respectively. An endoscopic score was used for only 10% of inflammatory bowel disease patients. About one third of inflammatory bowel disease patients had imaging studies within the past year (magnetic resonance enterography in 65%). An abdominal computed tomography scan was prescribed for 12% of inflammatory bowel disease patients.
Many patients still have active disease in the biologics era, and the number of patients receiving combination therapy is low in private practice. Chromoendoscopy and endoscopy scores are not often used.
关于炎症性肠病当前管理的数据稀缺。
这是一项针对2012年在法国治疗炎症性肠病患者的65名私立胃肠病学家的全国性调查。
共分析了375例炎症性肠病患者：48%患有溃疡性结肠炎。三分之一的炎症性肠病患者有住院史，40%的克罗恩病患者曾接受过手术。三分之二的炎症性肠病患者患有活动性疾病。接受抗肿瘤坏死因子治疗的溃疡性结肠炎患者明显少于克罗恩病患者（18.9%对38.9%；p<0.0001）。在接受抗肿瘤坏死因子治疗的患者中，只有4.5%同时接受免疫调节剂治疗。一半的炎症性肠病患者在过去一年中接受过结肠镜检查。对于结直肠癌筛查，分别有75%和40%的病例进行了随机活检和色素内镜检查。仅10%的炎症性肠病患者使用了内镜评分。约三分之一的炎症性肠病患者在过去一年中进行了影像学检查（65%为磁共振肠造影）。12%的炎症性肠病患者接受了腹部计算机断层扫描。
在生物制剂时代，许多患者仍患有活动性疾病，在私人诊所中接受联合治疗的患者数量较少。色素内镜检查和内镜评分不常使用。
